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Subject: Treatment of Essential Tremor (AAN 2003) Date: 4/11/2003 E-MOVE reports from the 55th Annual Meeting of the American Academy of Neurology, held in Honolulu March 29-April 5 2003. Poster numbers, session numbers, and pages are from Neurology 2003;60.1. A 9-year follow-up review of essential tremor patients who underwent deep brain stimulation of the thalamus KE Lyons, SB Wilkinson, R Pahwa P02.065; A123 Of 119 patients receiving thalamic DBS for essential tremor, 50 were still being treated, 10 had been explanted, 21 were deceased, and 36 were lost to follow-up. Among all patients, there were 15 lead replacements, 12 lead revisions, 9 extension replacements, and 42 battery replacements. Among the still-treated patients, mean improvement in total tremor score after a mean of 39 months (range 3-98 months) was 45%. 2. Topiramate in essential tremor: Pooled data from a double-blind, placebo-controlled crossover trial J Hulihan, GS Connor, SC Wu, K Edwards, D Tarsy, L Kraut P04.068; A291 Topiramate can reduce tremor, according to this study. Sixty-two ET patients were randomized to placebo or topiramate, titrated up to a maximum of 400 mg over 8 weeks, with two weeks maintenance, two weeks washout, and crossover to the other treatment arm. The most common adverse events were paresthesias and difficulty concentrating. Twenty-eight patients (18 on topiramate) discontinued. For completers, topiramate improved scores on the Tremor Rating Scale by approximately 1 point over baseline (p<0.001), versus no change for placebo. Improvement was smaller but still significant when all patients were included in the analysis. Supported by Ortho-McNeil Pharmaceutical --- E-MOVE meeting reports are funded in part by unrestricted educational grants from these sponsors: Gold Level: Bertek Pharmaceuticals Silver Level: Amarin Pharmaceuticals Bronze Level: Allergan Inc., Procter & Gamble Pharmaceuticals, Schwarz Pharma E-MOVE Editor: Richard Robinson, NASW, WE MOVE
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